The present invention relates to improvements in smoke removal in surgical areas, and more particularly to a smoke evacuating device for surgical use, which is simple in structure, can be made of low cost materials, and as a result is disposable.
Handheld electrosurgical instruments are well known in the art. These instruments take the form as electrocautery or laser surgical devices which are used in a multitude of different types of surgeries for the bloodless cutting of tissue with the simultaneous cauterizing of vessels which stop the bleeding. During surgical use, localized heat generated by the electrical discharge or heat source causes noxious smoke to be produced. Because of the high temperatures, the smoke cloud rises rapidly from the point of the incision by the cautery instrument.
Surgical drapes are well known in the art. They are used in minor and major surgeries to keep the operating field sterile and free from contamination. Typically, the surgical drape is fenestrated and has an aperture to enable the surgeon to access the surgical site without contaminating the surgical field. The surgical drape, as it is currently used, has no other function other than to serve as barrier that offers protection from contamination of the surgical field.
Even in the presence of current surgical drapes, the smoke produced during electrosurgery, often has a strong, persistent and unpleasant odor. This noxious odor can cause a vaso-vagal response in conscious patients undergoing minor surgery. Additionally, the smoke comprises organic gases, water vapor, visible and sub-visible solid particles, infectious microbacterial organisms, infectious viruses and virus particles, and carcinogenic substances, each of which is potentially harmful to the patient and the operating room staff. As a result, it is considered good practice to remove the smoke from the surgical field and filter it to minimize any potential harm. Lastly, when produced in sufficient volume, the smoke obscures the surgeon's view of the operative field.
There are prior art systems, making use of a vacuum to remove the smoke, such as that known from U.S. Pat. No. 5,460,602, which places a vacuum nozzle adjacent the cutting tip of the electrocautery device. This device has been satisfactory, however, it suffers from the disadvantage that it requires an entire distinct system which is siamese connected to the existing surgical instrument. This results in a more complex structure, which changes the feel of the surgical instrument, and by adding size to the surgical instrument also may obscure the surgeon's view of the operative field.
Because of this, it is still common practice to have an assistant hold a separate evacuating device near the surgical area. However, this suffers from the disadvantage of requiring two people, who often when not in full coordination, interfere with each other. And, since an additional person is holding the evacuating device in the surgical field, the procedure may require an additional third person to provide surgical assisting such as cutting sutures, retracting tissue and holding instruments in the surgical field. However, too many people can become cumbersome for the surgeon particularly in limited surgical areas. There is also the opportunity cost of requiring additional people for a single operation. Additionally, the use of vacuum devices generating adequate suction is a deterrent to the surgeon as a result of the noise created by the vacuum frequently over 80 db and affecting communication with staff and patient. Lastly, vacuum devices also suffer from power inefficiencies.
It is also known from the art from U.S. Pat. No. 4,921,492 to use a plume evacuator and effector. The plume evacuator includes an evacuation hose adapted for detachable connection to a vacuum generator. There is a filter along the hose. The vacuum head is made of a pliable material to define an evacuation plenum. A porous plenum supporting material is carried within the plenum to provide rigidity to the plenum and to prevent the plenum from collapsing when subjected to the vacuum. This prior art device has also been satisfactory, but it still requires the use of a hose integrally formed with a plenum coupled to expensive noisy and inefficient vacuum equipment. The plenum is integral with a flexible hose which is coupled to a collector head within the plenum formed of a non-porous, pliable synthetic resin. While the pieces are formed of resin, and reusable as the resin may lend itself to a sterilization process, resin pieces are still expensive, and may not be amenable to complete sterilization given the length of the hose necessary to reach a vacuum.
Currently, all prior art systems require the addition of another piece of equipment/device to the surgical field. That device is the sterile surgical drape. All prior art must avoid disturbing the sterile surgical drape and the sterile surgical field or any sterile surgical instrument. The necessity of prior art to avoid contaminating the sterile surgical field and still obviating the need for a surgical drape is often disruptive and burdensome to the surgeon and may be disruptive to the surgery. Prior art necessitates a change by the surgeon to either his instruments, surgical staffs and surgeon's approach to the surgical field, or communication with the patient such that most surgeons choose to not use prior art at great health risk to the surgeon and the patient. Prior art solutions are not readily adopted because it requires these changes and adjustments by the surgeon and the staff.
Accordingly, a plume evacuation system which overcomes the shortcomings of the prior art is desired.